Antimicrobial Use in the Community

Most antimicrobial use occurs in the community setting, which includes general practice, specialist outpatients, dental clinics and aged care homes. In 2015, around half of the Australian population (44.7%) had at least one antimicrobial dispensed under the Pharmaceutical Benefits Scheme (PBS) or the Repatriation Pharmaceutical Benefits Scheme (RPBS), with 3.2% of this cohort having six or more antimicrobials, including repeats dispensed.

AURA uses data from a number of sources to better understand the number of antimicrobials used within the community, the number of prescriptions for antimicrobials and to assess the appropriateness of antimicrobial prescriptions.

The Australian Government Department of Human Services (DHS) collects data, in the Medicare pharmacy claims database; and, on antimicrobial dispensing in the community through the PBS and the RPBS.

The Australian Government Department of Health (Department) analyses PBS/RPBS data to inform policy development and economic analyses. Comprehensive medicine usage data are required for a number of purposes, including pharmaco-surveillance, and evaluation of initiatives to promote quality use of medicines. It is also needed by regulatory and financing authorities, and the pharmaceutical industry for monitoring and evaluation.

Data captured by the PBS/RPBS are extensive. Overall, around 30.5 million antimicrobials were dispensed in 2015, with amoxicillin, cephalexin and amoxicillin-clavuanate accounting for 84% of the prescriptions. The Department‘s Drug Utilisation Sub-committee (DUSC) has published a comprehensive report on antibiotic utilisation which has also informed AURA’s work in this area.

In addition, NPS MedicineWise manages a program called MedicineInsight which collects longitudinal clinical data from general practices. The data and information collected includes the volume of use of medicines, switching of medicines, the indications for prescribing, adherence to the Therapeutic Guidelines Antibiotic and information about pharmacovigilance, to support post-market surveillance of medicine use in primary care.The Program also supports general practice improvement in quality use of medicines and medical tests. The program aims to support changes in prescribing patterns by providing local data to general practices, to better understand where there may be variation and opportunity for improvement.